Individual
EMILY BLAZEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N 18TH ST, PHOENIX, AZ 85006
(602) 340-8717
Mailing address
300 N 18TH ST, PHOENIX, AZ 85006-4103
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-30031
AZ
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/29/2017
Last updated
05/24/2018
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